Co-Payment and Sub-Limits in Insurance

 These are features bring down the liability of the insurer as well as your premium. Co-payment means that the insurer will not pay the full amount but only a certain percentage. It exists mostly in health insurance plans for senior citizens. For instance, a policy that offers medical insurance of R2 lakh and co-payment clause of 10% will pay only R45,000 if the total hospitalisation bill comes to R50,000. Co-payment could also be on certain specified ailments. Some insurers may ask you to pay extra to waive off the co-payment clause.

You also need to go through the sub-limits in a policy. These are usually found on room rents, which means the insurer has capped the amount eligible. You need to be careful about its as it's not just the room rent but all associated costs like doctor's fee that automatically get capped.